The Trump administration has decided to begin phasing out U.S. HIV funding for South Africa, citing what a State Department official described as the country's failure to address concerns raised by President Donald Trump regarding the treatment of white Afrikaners.
The decision marks a further deterioration in relations between Washington and Pretoria and will affect funding provided through the President’s Emergency Plan for AIDS Relief (PEPFAR), a major source of support for South Africa’s HIV response.
South Africa has rejected allegations that it discriminates against Afrikaners and has defended policies aimed at addressing inequalities rooted in the apartheid era.
According to a U.S. State Department official, the phased drawdown follows repeated warnings from Washington that PEPFAR funding could be terminated unless South Africa made progress on policy issues identified by the Trump administration.
The move aligns with a February 2025 executive order that accused South Africa of discriminating against its white minority population and directed U.S. agencies to halt aid unless policies were changed.
The order also referenced South Africa’s legal case against Israel at the International Court of Justice and its ties with Iran.
The Trump administration has additionally granted refugee status to Afrikaners seeking relocation to the United States.
South African officials have disputed the administration’s claims and maintained that measures such as Black Economic Empowerment are intended to address longstanding economic disparities.
South Africa has the largest population of people living with HIV in the world, with more than eight million people affected.
PEPFAR funding previously accounted for roughly one-fifth of the country's HIV spending and provided hundreds of millions of dollars annually for treatment and prevention efforts.
U.S. government data showed South Africa received approximately $456 million in HIV/AIDS funding in 2024, falling to $213 million in 2025, while only $25 million has been allocated so far this year.
A State Department official said the administration's objective is to encourage self-reliance, arguing that South Africa is capable of funding its own health programs.
South Africa's health ministry said it has been preparing a self-reliance strategy and emphasized that life-saving antiretroviral medicines are largely financed by the government rather than through PEPFAR.
The State Department has not provided a timeline for when the phased withdrawal of funding will be completed.